| NPI | 1063944924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD H0091533) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: DC DO200001201) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2021-07-15 |